HomeMy WebLinkAboutHomestead_WesterfieldINDIANA SALES DISCLOSURE FORM SDF ID: Pa St 2
D. PREPARER_ -... - .. ..
DAN L. REEVES ATTORNEY
Preparer ofthe Sales Darlosure Form Title
REEVES & COCHREN
Company
PRINCETON. IN 47670
Email
LI
Segerl Na measappearsenconveyancedocument
MARCIA DOERNER
Seller 2 - Name as appears on conveyance document
7131 VEGA WAY APT 252 P.O. BOX 262
Address (Number and Street) Address (Number and Street)
INDIANAPOLIS IN 46241 SOMERVILI E IN 47683
Ciry, State, and ZIP Code Ciry, State, and ZIP Code
Under penalties of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by la and is prepared in accordance with IC 6- 1.1 -S.S, "Real Property Sales Disclosure Act ".
Signatureo Iler Signa re of Seller
PHILLIP CHURCH 1/13/2012 MARCIA DOERNER 1/13/2012
F. BUYER(SI /GRANTEETSI-�,APPLICATION FOR PROPERTY TAX DEDUGT-MNS- IDENTIFYACL,ITEMS THAT APPLY
Buyer as appearsanconveya edacument
u erZ Nomeosa rorson ronvev dacumem
NName
10242 E. ILLINOIS ST.
Mumber and Street)
Address (Number and Stmt)
SOMERVILLE, IN 47683
SOMERVILLE, IN 47683
Ciry, State, and ZIP Code
City, State. and ZIP Cade
FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION NO CONDITION
0 ❑ 1. Will this property be the buyer's primary
3. Homestead
residence? Provide complete address of pr ary
4. rgy Heating /Cooling System
residence, including county:
❑ ❑S. Wind Power Device
10242F ILLINOIS ST.
❑ [Z] 6. Hydroelectric Power Device
Address (Numberand Street)
SOMERVILLE IN 47683 GIBSON
❑ [Z] 7. Geothermal Energy Heating /Cooling Device
❑ ❑� 8. Is this property a residential rental property?
City, State ZIP lode cmmty
❑ ❑✓ 2. Does the buyer have homestead in Indiana to be
a
vacated for this residence? If yes, provide
❑ ❑✓ 9. Would you like to receive tax statements for this
complete address of residence being vacated,
property via e -mail? (Provide contact information
including county:
below. Please see instructions for more information.
Not available in all counties.)
o� (G - 2-o -0a yQ a 00o 03$ CO-3
Add.(Numberand Sweet)
WILLIAM M. WESTERFIELD
City, State ZIP Cade County
Primaryproperry ownerconma name E -mail
Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note:
Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is
being filed.) A f)_ nn In. N ^ I, I I to -0 A
Signature ofBayerl
Dote(nM /DD/Y1y) I Printed Legal Name of Buyer Z /Spouse Sign Dow(MM /a0 /YYYn
Security
License /ID10ther Number Number License /ID10ther Number